STORIES

Research With Impact: Changing Global Health Practices

Professor Ashraf (center) with members of the study implementation team at Chipata Clinic, Lusaka, Zambia, including fi eld managers, surveyors, community health workers, and a study nurse. (click for larger view)

Investing in HBS

Associate Professor Nava Ashraf, the MBA Class of 1966 Research Fellow, exemplifies one of the many HBS faculty members who is actively overturning prevailing assumptions to develop more successful approaches to persistent business, public policy, and social challenges. In health care, for example, the dominant policy model assumes that access and affordability are the keys to improving care for the poor.

In Ashraf’s view, “We can’t solve the challenges of global health without deeply understanding what motivates customer and provider behavior.”

To that end, Ashraf has designed and conducted numerous field studies, including several in Zambia. One study targeted Zambia’s high birthrate with an experiment based on improving access to modern contraceptives. In the study, about 1,000 women were randomly selected to receive vouchers for free contraceptives. Half received vouchers with their husbands present while the other half received them privately. A control group received no vouchers. The goal? To measure the influence of spousal pressure in a nation where men generally want more children than women do.

The results were revealing. Providing inexpensive and convenient forms of birth control was not sufficient. Unwanted births declined only when women were given full autonomy over access to contraceptives. These women had a 57 percent reduction in unwanted births. The Zambian Ministry of Health took notice and has used the research findings to change its approach to the issue.

Ashraf says that “in both the private sector and the world of global health, effective solutions require understanding the specific context.” Achieving that understanding, especially within a global context, is expensive. International case studies, for example, are five times more costly to produce than domestic ones. Conducting the intensive, field-based experiments that Ashraf’s research requires depends on even greater resources than those needed to write a case.

HBS is committed to the global research that professor Ashraf and her colleagues are doing. “This commitment to developing ideas with impact not just in academia but also in practice and in policy,” says Dean Nitin Nohria, “is a vital part of our identity and DNA.”